title: [Surgery for benign schwannoma arising at the thoracic apex].
abstract: It is difficult to determine surgical approaches for treating a tumor arising at the thoracic outlet. Here we report a case of benign schwannoma arising at the thoracic apex, in which both pleural and cervical approaches were adopted. Chest radiographs of a 58-year-old male at the medical checkup in 2009 showed a tumor shadow in the right apical region that was increasing since 2003. He had no symptoms. Computed tomography(CT)and magnetic resonance imaging (MRI) showed a 35-mm tumor, which had a smooth surface and was suspected as a neurogenic tumor arising at the right thoracic outlet. Surgery for this tumor was performed by the thoracoscopic approach with a mini thoracotomy through the 3 intercostal space 1. The tumor was suspected to arise from the brachial plexus, and was not able to be enucleated. Then we made a cervical incision and the tumor was resected safely using a pleural approach together with a cervical approach. The pathological finding was benign shwannoma. Mild ulnar nerve palsy was observed in the patient after surgery, which gradually improved within 3 years.
authors.affiliation: Department of Thoracic Surgery, Hyogo-Chuo National Hospital, Sanda, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takata
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000379:methods